The major differences between Associate degree of nursing and Baccalaureate of science degree of nursing are the time of study for each degree as well as the overall content learned by the nurses in the programs. The associate degree focus is normally a two year program; however there exists fast track programs and one can achieve an ADN in 18 months and sit for the NCLEX-RN. These programs focus on skill sets, illness and illness prevention, lacking theory, a science and research base. This is due primarily on time restraints of the program (Deloughery,1991; Zerwekh & Claborn, 1997; Catalano, 2000). The BSN is a four-year degree and has the focus of the patient as a whole through theory, science, evidence based practice, research, cultural diversity, spirituality, ethical, legal and global perspectives. Achieving either of these two degrees qualifies a person to sit for the NCLEX-RN; which only measures the minimal technical competency for safe entry into basic nursing practice. (http://www.aacn.nche.edu/media-relations/NursingWorkforce.pdf)
There are many situations that can be described how nursing care or approach differ between ADN nurses as well as BSN nurses. The first example is the traceable patient outcomes, in an article published in Health Services Research in August 2008, it examined the nursing effect of nursing practice environments on outcomes of hospitalized cancer patients undergoing surgery, it was found by Dr. Christopher Friese and colleagues that nursing education level was significantly associated with patient outcomes. The nurses prepared at the baccalaureate-level were linked with lower mortality and failure-to rescue rates. (Health Services Research, 43 (4), 1145-1163.) Baccalaureate programs offer more advanced education in areas that support critical thinking, clinical reasoning, and analytical skills; prepare nurses for a broader scope of practice; further professional development; and facilitate understanding of complex issues affecting healthcare delivery. In our ever changing medical profession, the guidelines for patient care and outcomes of our patient’s and patient safety greatly affect the care the hospitals and facilities are guided through JCAHO and Medicare for payment. This is pushing the trend for hospitals to hire nurses with BSN’s versus the ADN, and thus setting incentives for existing nurses with ADN’s to go on and further their education. With the implementation of Accountability Measures it has become critical that our nurses understand and are capable to facilitate the needed actions for the patients. The goal between CMS and the Joint commission who precisely aligned the measures together, is to focus on the data collected between these core measures to improve the healthcare delivery process (Joint Commission.org). Thus pushing the trend for hospitals to become magnet hospitals with employing strong, educated nurses. There are 14 forces of Magnetism as stated by (nursecredentialing.org). The 14 describe nurses with BSN level education and beyond.
In the field of nursing that I currently practice we are guided by state funded agencies to follow a criteria of dimensions for admission of a patient that may need medical detox. These are the three ASAM dimensions the crisis and detox nurse evaluates to determine the proper care of the patient. Dimension 1 focuses on the physiological effects of acute intoxication and the potential of the patient to experience drug withdrawal symptoms (www.asam.org). The nurse evaluates the drug use history, current withdrawal symptoms, history of withdrawal, support systems in place, living situation, to evaluate the specific needs of the patients. Dimension 2 focuses on medical history, does the patient have a medical history that may hinder the success of detoxification. Is the patient medically clear to be